Chinese medicine: When you do things to the extreme

Chapter 246: Late understanding is also understanding!
Zhou Yanqing and Chai Zhonglin were in the emergency department, not far from the rescue area.

Chai Zhonglin kept answering the phone while jogging. He did not explain anything to Zhou Yanqing. After running for a while, he quickly said, "Rescue District 2. I'll be there right away!"

"Rescue Area 2!" Chai Zhonglin was afraid that Zhou Yanqing didn't hear clearly, so he accelerated immediately after he said it.

The corner of the white coat remained there for a few seconds due to inertia before being pulled away by Chai Zhonglin.

Zhou Yanqing took two seconds to react, but his pace was faster, and he caught up with Chai Zhonglin after five or six seconds.

"Be careful!" Chai Zhonglin didn't have time to explain the details.

The two tall and strong men in white coats were running fast, causing the patients and their families to avoid them. Then they followed their gazes, perhaps feeling strange.

Soon, the two arrived at the rescue area 2.

A pool of blood could be seen on the ground between the emergency beds, and a group of people in white coats and green nurse uniforms surrounded a bed.

He Qingqing, deputy chief physician on duty, spoke calmly and in an orderly manner.

Not an order.

It was said: "Direct tracheotomy and ventilation!"

"Establish intravenous access!"

"Norepinephrine intravenous push, prepare two pumps!"

"Press temporarily to stop the bleeding, call the general surgery and vascular surgery departments..."

"Director He, the bleeding won't stop!~" A nurse pressed the patient's legs, with blood beads on her mask and right eyebrow!
The green nurse's uniform was sprayed with a blood sword.

Zhou Yanqing and Chai Zhonglin had already prepared the examination gloves and put them on their hands. After approaching the bed, they slowed down their pace!
He Qingqing didn't care about being interrupted and continued to give orders.

Start walking around the bed, find the view first!
In an emergency, you cannot panic and you cannot crowd into the room. If you push away a critical bleeding point, the patient's life risk may increase tenfold immediately!
Naturally, when the two of them went their separate ways, they were whispering, "Orthopedics!~"

"It's convenient to make room."

Perhaps only the nurses surrounding the bed know who will be more convenient to make room!

Zhou Yanqing was luckier, as soon as one of his small figures retreated away.

"He was sent here with a temporary bandage at the scene, and after he was pushed off the ambulance..." the young nurse explained.

There was also the complaint of the previous patient: "What should I do here?"

"Where are the people! Where are the people!"

"Shut up!" When the little guy saw Zhou Yanqing going in, he turned around and scolded him.

"I'm an emergency patient too!~" The man couldn't believe that he was being confronted by a gentle-looking nurse.

"Shut up!~" the little guy immediately retorted.

I didn’t dare to confront him before because it was a sign of respect. Now confronting him is a sign of even greater respect for others…

Zhou Yanqing approached the bed and had time to look at the location of the patient's blood.

There was a hole in the right lower abdomen, and the right forearm, right thigh and right calf were all bloody.

Although wrapped in a large amount of gauze, clothes, and bandages, blood was still oozing out.

In such cases, it is difficult to determine the specific bleeding points in the upper and lower limbs.

While my thoughts were wandering, the alarm sound of the monitor came in "beep beep beep"!

"Pressurized infusion! The patient's blood pressure is too low." He Qingqing turned around and gave instructions to the nurse.

In emergency rescue, replenish blood volume first.

While stopping the bleeding, you must also replenish blood volume at the same time. Replenishment has a higher priority than anything else!
"Knife!~"

"Debridement pack!" Zhou Yanqing whispered.

The situation at the scene was so chaotic that Zhou Yanqing had no time to clean up the bleeding spots!
Now, fluid replacement is just as important as super effective hemostasis!
"The debridement pack has been opened. It's on the other side!" said the nurse next to Zhou Yanqing.

"Open again, knife! Knife!~" Zhou Yanqing stood up and looked around quickly.

My mind is also racing.

If we try to stop the bleeding bit by bit now, it will definitely not be enough and the patient will eventually go into shock. The only thing we can do is to directly clamp the bleeding valves of the limbs, that is, the left and right common iliac arteries and the left and right subclavian arteries as soon as possible.

First, violently close the valve that causes blood loss from the limbs!

This may increase the risk of necrosis in the patient's limbs, but it is the only fastest and most effective way to reduce blood loss!

A curved plate was placed on the patient's chest by the person opposite.

"Debridement packs, open at least three!" Zhou Yanqing picked up the scalpel, held it in his right hand, and then violently cut the patient's clothes without hesitation.

It revealed his right lower abdomen area!

The patient had already fallen into a coma and I didn't know whether he was conscious or not, but it was too late to care about him at this moment.

After making a three-centimeter-long incision along the right abdomen, Zhou Yanqing did not have time to get tweezers, so he used hemostatic forceps to violently and bluntly break open the subcutaneous tissue layer and the fat layer.

Extravasation of blood from the wound.

Zhou Yanqing continued to peel it inwards, and the muscle layer was torn apart by Slas!

Zhou Yanqing didn't want to waste even a second looking for the intermuscular gap!

After reaching the abdominal wall layer, Zhou Yanqing paid a little attention to the direction and directly pierced the abdominal wall with a round knife!

At this time, there is no time to change the sharp blade.

Time is everything, time is life!

After the abdomen was opened, blood oozed out and covered the organs in the abdominal cavity, leaving little room for vision.

But this did not affect Zhou Yanqing's left hand which drilled directly in!

The first thing Zhou Yanqing wanted to find was the left and right common iliac arteries, so as long as he found the bifurcation of the abdominal aorta, everything would be easy!
The position of the abdominal aorta is relatively fixed.

After Zhou Yanqing's left hand touched it, it slid down quickly.

It bifurcates to the right, forming the common iliac artery.

As soon as the left hand arrived, the hemostatic forceps in the right hand were already pushed in, and clamped closed with a click!

Zhou Yanqing saw that there was no equipment in the curved tray and no one could keep up with his operating speed, so he shouted: "Hemostatic forceps!~"

“It’s open!”

"Hurry up, pull it apart, don't care about the principle of sterility!" Zhou Yanqing shouted angrily.

Zhou Yanqing didn't know how much time had passed since he got the scalpel, he only had one request!
fast!
Faster!

Spend all your efforts to be fast!
There was a tearing sound from the other side.

Zhou Yanqing's right hand passed through the crowd and was slapped with a hemostat.

"More!"

"Prepare it for me now!" Zhou Yanqing's left hand was still in the abdominal cavity, and he had already found the position of the left common iliac artery. After the incision in the abdomen was exposed, there was no need to consider whether it was the left common iliac artery or the right one, and both sides could be temporarily clamped!
After another click.

Zhou Yanqing stretched out his left hand, and he instinctively wanted to reach his right upper arm to deal with the right supraclavicular artery!

However, while pulling back his left hand, Zhou Yanqing's palm felt the direction of the blood spraying out of his body.

This feeling is fleeting, and this direction may not be found so accurately next time!
Seeing that Chai Zhonglin on the opposite side was still trying to open the gauze bandage to stop the bleeding locally, Zhou Yanqing quickly said: "Brother Chai, tie up the left and right upper arms in a tourniquet-like manner to stop the bleeding!~"

"Use gauze as a rope and tie it up directly. Tie it as tight as you can. Give me a minute!"

Chai Zhonglin looked up when he heard this, full of doubts: "But here?"

The situation was urgent and everyone was doing their own thing. He Qingqing and others were still making other preparations, so the two had no time or space to communicate at all.

"I closed the left and right iliac joints!" Zhou Yanqing said, and then another hemostatic forceps was slapped on his right hand.

Zhou Yanqing quickly put the thumb and ring finger of his right hand into the ears of the hemostat, and moved his left hand in the pool of blood in the direction of the blood spurting.

Blind Detective!

Zhou Yanqing didn't know which blood vessel was problematic. There were only a few exposed openings, and with no vision, he could only explore blindly.

Finally, when he reached the right renal artery, Zhou Yanqing felt the maximum vortex force of the blood gushing out.

The index finger and thumb of the left hand hold it without hesitation!
His right hand reached into the patient's abdomen again, drilling into the patient's body like a knife. He inserted a hemostatic forceps, bringing out bright red blood.

The right elbow of Zhou Yanqing's white coat was already bright red!
Chai Zhonglin had already been asked to deal with both upper arms, so Zhou Yanqing stopped talking and began to move his left hand around the surface of the abdominal cavity!
Right ureteric artery. Clamp it!
Just after Zhou Yanqing clamped it again, he discovered something wrong.

The patient was lying flat on his back, and he felt the upward force of blood on the hypothenar eminence of his left fingertips!

What is this? After the aorta is blocked, the small opening in the abdominal aorta may be tearing rapidly!
If the blood cannot complete circulation, the local pressure will increase and the local blood pressure will be much higher than the normal blood pressure of the human body!
However, after Zhou Yanqing looked inside again, he breathed a sigh of relief. This was not a hole in the abdominal aorta, but just an innominate artery with a small diameter!

However, the bulging abdominal aorta could be felt very clearly in Zhou Yanqing's palm.

"Establish temporary arteriovenous extracorporeal circulation!"

"The patient's intra-abdominal bleeding and bleeding in both lower limbs have been temporarily dealt with!~" Zhou Yanqing stretched out his left hand and reported to He Qingqing.

He Qingqing was originally checking the patient's ventilation condition. When she heard Zhou Yanqing's report, her tone paused.

He turned his head and glanced at Zhou Yanqing, then instructed the nurse: "Measure your blood pressure, measure your blood pressure at any time!~"

The nurse pressed the button for the blood pressure test.

Zhou Yanqing went to the direction of his right upper arm!

If the bleeding in both lower limbs and most of the bleeding in the pelvic cavity have been temporarily dealt with, the only thing left is the bleeding in the upper limbs.

While Chai Zhonglin was doing one thing, he was doing the other, and then quickly returned to the lower limbs to treat the local and suspected active arterial bleeding in the pelvis.

In this way, the blood circulation in the head is unobstructed, and other organs are not so prone to necrosis!

As long as brain death doesn't occur, there is still a chance!

"One and a half minutes! Director He." A nurse's voice sounded in He Qingqing's ears.

Upon hearing this, He Qingqing looked in Zhou Yanqing's direction again. Zhou Yanqing had already cut the gauze again and, with great skill and courage, directly clamped the proximal end of the patient's injured brachial artery with a vascular clamp!

Moreover, at this time, Zhou Yanqing was already quickly treating the distal artery to prevent reflux blood loss!

"Blood pressure, 82/52 mmHg! Blood oxygen 83!" The nurse near the monitor quickly read the vital signs.

"The high voltage has increased by 12!"

"Slow down the infusion speed, ask the blood bank for blood components, and draw electrolytes and blood routine!"

"I need 4 units of platelets and 400mL of plasma." He Qingqing then had the opportunity to elaborate on the doctor's instructions.

At this time, the white coat of Associate Professor Yang Lingchong from the Vascular Surgery Department who had been sent to come finally arrived.

While Yang Lingchong and another person were putting on gloves, they saw the standard incision on the patient's abdomen and the two ears of the needle holder on the surface of the incision.

Maybe the other person's manipulation was quite powerful, the two ears of the needle holder were still shaking gently, as if mocking the incompetence of the god of death! ~
"This???" Yang Lingchong immediately saw the most dazzling man at the scene.

His body was covered in blood and his sleeves had turned black and red, like a butcher who had just come out of a slaughterhouse.

He lowered his head at this moment and carefully clamped a vein again!

……

Three minutes later, Zhou Yanqing left the area surrounding the bed.

Because the patient's vital signs have become almost stable, the remaining operations can be left to Yang Lingchong and Chai Zhonglin.

He had just acted so cowardly that he had ruined a white coat, and his shirt was also stained with the patient's blood. Zhou Yanqing, who was a bit of a germaphobe, would never want it again.

But it doesn’t matter. The dozen or so shirts he bought recently were all cheap ones that Zhou Yanqing purchased in bulk.

Take it off!
Throw!
Zhou Yanqing took a deep breath and felt a little distressed.

Such a rescue operation would cost a hundred and twenty dollars.

Two hundred and forty twice.

If it happens thirty times in a month, the loss will be more than three thousand.

"Oh!~" Zhou Yanqing murmured in a low voice, feeling speechless.

It's really unheard of to have to pay for work.

Mainly because the weather is quite cold now!
Wearing short sleeves is not rigorous enough. Next time, why not just use surgical gowns as daily equipment, send them for disinfection directly, and reuse them!

When Zhou Yanqing sorted out his new shirt, he found blood stains on his pants!
"Well, the gift Xiaoyu sent is gone, and this pair of pants is more than 400 yuan!" Zhou Yanqing smiled and stuck out his tongue!
There is an indescribable urge in my heart!
Zhou Yanqing was not sure about the previous rescue, but in the last one, he was sure that if he delayed for even one minute, he would definitely die!

Fortunately, I ran faster than time.

His own sword was more powerful than the scythe of the god of death.

My own pliers overturned the whips of the Black and White Impermanence...

Zhou Yanqing returned to the emergency room again.

I watched the rescue going on, watched the patient's vital signs gradually return to normal, and watched Chai Zhonglin methodically handle routine orthopedic operations - debridement and suturing.

Watching Yang Lingchong once again explaining to Xiang Miao from the Department of Vascular Surgery the significance and convenience of the incision made by Zhou Yanqing.

"This kind of ultra-violent and ultra-fast rescue is more common in military hospitals. There, only practicality is important. It is not convenient for other colleagues to watch the rescue process, let alone family members!"

"If you don't know, it will be considered murder."

"To do this, one needs to have very clear logical ability, very precise cutting and exposure ability, as well as the ability to stop bleeding with bare hands and blind operation!"

"Some excellent trauma doctors can even perform a life-saving spleen removal on the spot in less than two minutes."

"Even if the liver is ruptured, there is a way to treat it..." Yang Lingchong said as he glanced in the direction of Zhou Yanqing.

Chai Zhonglin lowered his head, his lips mumbling silently behind the mask.

Struggling inside! ~
He understood what Director Lei Zhong meant, but he was still struggling...

(End of this chapter)